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Health Minister Ya'acov Edri praised the cabinet and Acting Prime Minister Ehud Olmert Sunday for expanding the basket of health services by NIS 310 million instead of the NIS 164m. originally budgeted by the Treasury. However Israel Medical Association chairman Dr. Yoram Blachar poured cold water on the decision, calling it "calculated manipulation" by the Finance Ministry.
Blachar said the whole exercise was phony. A total of NIS 200m. of the NIS 310m. promised by the Treasury, he said, would be spread over the seven months remaining in 2006 once the budget was approved, and NIS 110m. would be transferred to the 2007 budget. "Thus, in fact, there would be no real increase, unless it becomes clear that the annual budget base would be increased by NIS 310m."
Blachar said it was the first time that the cabinet had not accepted the committee's recommendations in full - in this case, to raise the annual basket by NIS 466m. - and that "the Treasury's budget division will surely celebrate its victory over patients."
Before Sunday's cabinet meeting, Olmert - a former health minister - told Edri that the basket would be expanded by nearly double the original figure. The National Health Council and the professional committee on expansion of the basket 10 days ago recommended an increase of NIS 466m. for 2006.
Edri, whose portfolio has been demanded by both the Gil Pensioners Party and Shas, told health reporters in his office he hoped the next government would expand the basket by even more. He said he wanted to add members, especially public representatives and ethics experts, to the committee that recommends new drugs and technologies for the basket, and would push legislation that would automatically expand the basket by a fixed percentage, such as 2 percent, each year.
The annual sight of Health Ministry officials begging Treasury budget officials for funds, the lobbying by pharmaceutical companies and demonstrations by patients desperate for lifesaving drugs were embarrassing and could be eliminated by setting a fixed annual increase, Edri said.
Blachar also criticized the cabinet's decision to wait at least until June to add a new use for the drug Herceptin to the basket. That decision was made because it had not yet been approved by the US Food and Drug Administration or European regulators for preventing the recurrence of breast cancer in certain patients who have already undergone surgery, chemotherapy and/or radiotherapy for their tumors.
"This contravenes the recommendation of the basket committee, which urged its immediate introduction into the basket for such patients because its efficacy has been proven without a doubt," said Blachar.
"The matter of medicines in the health basket is not a coalition issue," Olmert said at the cabinet meeting. "This is human life and I previously instructed the Health Ministry and the Finance Ministry budget division to find a way to increase the health basket so that we will be able to meet the special needs of a large population in the state of Israel who need medicines, essential medicines for saving human lives. I hope that the proposal will be approved by the cabinet today."
"It is never possible to give total approval to all applicants for whatever is likely or liable to arise," said Olmert, "but it seems to us that this is a worthy proposal."
Edri said his office was negotiating with pharmaceutical manufacturers and importers about selling vital medications not included in the basket at "up to 50% less" than the regular price. The initial list, he said, would be announced after Pessah.
The drugs covered by the NIS 310m. include Crestor and Ezetrol to lower blood fats; Atacand, Oscaar and Ciovan for hypertension patients who cannot take ACE inhibitors; slow-release insulins for diabetics; drugs for HIV carriers, Prevnar vaccine against pneumococcus; Mabthera as a first-line treatment for follicular non-Hodgkin's lymphoma; Zyprexa and Seroquel for bipolar disease; Keppra, mostly for young people with epilepsy; Exjade for young people with excess iron in their blood; and Plavix for patients who have had a recurrent stroke after taking aspirin.
Many vital drugs, however, were not included in the basket increase.